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HomeMy WebLinkAbout030-110-08383 EDWARD H. BARRON SIS Grand Ave.,app. 500' W/of,16th "* ST., Oroville CONTR: Oro Pump & Electric,Orovilb IOU Permit #5168-75E(el(sr-. only for commercial mobile) i nGL1 0110r, 1 EL GAS SUPPORT S �2� C1URE REQ > COMPA ION TEST.REQ. s 030-110-083 4-2227 CHER, YANG LE® GRAND AVE, OROVILL Cont: WORLD FM CONS NEW SINGLE FAMILY r"- CW3 { i NOTES RESIDENTIAL 9 PERMIT N0. _ 030-110-083 (�Q r CHER, YANG Q . GRAND AVE, OROVILLE Cont: WORLD FM CONST NEW SINGLE FAMILY 04-2227 SPECIAL CONDITIONS . CHECKED BY SRA. FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY — USE PERMIT CONDITIONS — SUB -STANDARD HOUSING LETTER OFFICE COPY I / Address 1&--3 GAS 7Meter By Date ELECTRIC �/ Meter By �^✓l� Date/��/__ JOB FINALED (Date) 4- Signature r i 1 r �t t �I. +c s� 5 r f 04-2227 SPECIAL CONDITIONS . CHECKED BY SRA. FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY — USE PERMIT CONDITIONS — SUB -STANDARD HOUSING LETTER OFFICE COPY I / Address 1&--3 GAS 7Meter By Date ELECTRIC �/ Meter By �^✓l� Date/��/__ JOB FINALED (Date) 4- Signature ..,may-""r^a.•'P14."'n�,%''�... .Cry.*�,�.-.....•-..2--.i...a..�+7S=+r.%•..7+-:✓cr.w:iR+.•a�:"-'`+.`+••+.-•-.:`-v„_n..�3..w•-+�' t COUNTY OF BUTTE BUILDING DIVISION. ; DEPARTMENT OF DEVELOPMENT SERVICES 4114 Main Street • Chico, CA • (530) 891-2751 ` 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE . ,l y �tA f 6� Zz z OWNER PERMIT NO. u=w' A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, 4 please cgntact this office immediately. r° y- S n no Vkc> 1' y h �t . ,l COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES ' 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE ori- aaa�- OWNER H ' O PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please call for re -inspection when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact the Building Inspector as indicated below. Date q-,)(, l�� Inspector V REV 2/05 Phone # Si,�,:v'sc►*��ra.�' .�:ti ...r.. y-, ,,�,.,-��.,-,.-x-� �r'�*[��.i`r�,"�"'�r.'r^I.r.'w'r1+^fn`AT3�_`�7'+4•.r.:..�-.r-.�i T`-"#' t COUNTY OF BUTTE BUILDING DIVISION t. DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street,* Chico, CA • (530) 891-2751 7 County Center Drive _• Oroville, CA • (530) 538-7541 `' CORRECTION NOTICE VIA-i-,j��- X22 7 OANER PERMIT NO. r- 1 'c A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please Itact this office i0mediately. a. i i REV 10/92' BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP042227 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 09/21/2004 APN: 030110-083000 the Business and Professions Code, and my license is in full force and effect. , License Class : License Number: Site Address: 1663 GRAND AVE ORO � Date:' 'Y���/ Contractor: ~�%�.> ✓/C'� ^' ' ��?i' V Map Index: Description: NSF (1568) GAR(442)COV(346) OWNER43UILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: YANG, SENG & YANG CHER permit to construct, alter, improve, demolish, or repair any structure, prior AVE APT 4 to its issuance, also requires the applicant for such permit to file a 60. NELSON signed statement that he or she is licensed pursuant to the provisions of OROVILLE, CA the Contractor's State License Law (Chapter 9 commencing with Section 95965 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: WORLD F M CONSTRUCTION CO Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for 1617 71ST AVENUE sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of SACRAMENTO,CA 95832 proving that he or she did not build or improve for the purpose of (916) 870-2344 sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor:' WORLD F M CONSTRUCTION CO and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Business and Professions Code 1617 71ST AVENUE Date: Owner: SACRAMENTO,CA 95832 (916) 870-2344 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: O 1 have and will maintain a certificate of consent to self -insure for License #: 740981 workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as Architect' required by Section 3700 the Labor Code, for the performance of Engineer: the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 2446 S. F. Policy #: I certify that in the performance of the work for which this permit is Valuation: $123,914.00 issued, I shall not employ any person in any manner so as to Census Code' become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: ® /41/ ,f Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of damages for in Section 3706 of the Labor Z (o+2. 3-7 '7- :7- �¢ compensation, as provided ,e ,,� �p3 code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit i hereby issued under the applicable provisions of the Butte County CodR BnWor I hereby affirm that there is a construction. lending agency for the fo hich thi is issued 3097 Civ% Resolution to do work indicated above for which fees have been paid. 'J-.71-04 performance of the work permit (Sec `_ BY: nv Date: Name:`/T^P— !- • / • C 5 PER01EXPIRES ON: ��*�il•• � Address: /�%f1'l f0 rEi'� .G'� (Date) ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any offici;form or d ument of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. ,wPrint Name: '/i��A/� a /'L.&k/leiSignature: Date: zz!::J'emoi ❑ Owner �jContractor ❑ Agent for Owner 13 Agent for Contractor J=OK 0 = 'Not OK . NotApplicable Not Ready MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements r 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O -Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L 'ft. / P Nat. or/ /" L "ft./ P LPG 7. Well Clearance & Disconnect 8. Utilitv Clearance Date Card.13-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date - Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water; MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 't, . MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. 'Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3., Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing , 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures ? 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses - 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels 3 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 �. .. - r�'a'�w^�...:.•n.+r�..+c �"narF t+tia .,s��«.,.f�.w...r...�y.,....:��Fw..+r>.:.w''�,w.w�.....�o...rr......�.. ,.w=:w....-.._-•..,�... .:--.....�.. y`.;:.+.• . �. ter' 1.. � t:, - Date Card B-1 Date Card B-1 Date Card B-1 Dale Card'B-1' Date . POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.' Boxes- Enclosures- Panelboards-Ins. to Main Conduit 9. Health Department Approval 10.. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure;, Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 �. .. - r�'a'�w^�...:.•n.+r�..+c �"narF t+tia .,s��«.,.f�.w...r...�y.,....:��Fw..+r>.:.w''�,w.w�.....�o...rr......�.. ,.w=:w....-.._-•..,�... .:--.....�.. y`.;:.+.• . �. ter' 1.. � t:, - J=OK 0 = Not OK - = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) , Date UNDWLOOR (Plans) OK except #'s 10.­Zo 'ng -Setbacks -Easements -Flood -Slope t . ain; Soils-Elec. Grnd.-/ /" Ftg. Depth tg., Garage; Soils-Steel-Elec. Grnd.-/ P' Ftg. Depth Porches & Decks; Soils -Steel-/ P' Ftg. Depth telnwalls, Main; Steel-Blockouts-Wrapped r -6a. UKd Downs and Special Anchors &90.' D.W..; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 1 Water Pipe: Test-Anchors-Reaulator-Service Test ( t' %/12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Car -1 Date Card B-1 Date PL BING (Permit) OK except #'s er Htr.; Vent Access -Combustion Air Baffle 1 ter Pi st & Anchor -Nail Protection j9 .W.V; est Fittings & Anchor -Nail Protection -2Q Se=ver Pan; Test, First Floor -Tub Access Tub & Shower, Second Floor -Tub Access 2 Gas Pipe; Sixe & Anchors 23. Fire Sprinkler; Test Date �o Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECYh1CAL (Permit) OK except #'s Fi e & Transformer Clearance -Ins. Protection c. Receptacles Spacing -Lights & Switches at Doors iz Boxes & No. of Conductors Stapled 2 ex Installed Close to Edge of Studs & C.J. 28 quip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al j1_.�arfge Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or At /Insulated Neutral Q.Yes ❑ No 3 Service -Riser Conductors & Ground Main Disconnect 3 i . Clearances Panels-Motors-Mech. Equip. es Closet Light -Shower Light -Spa Light 35,Xmoke Detector Date Date Card B-1 Date Card B-1 Date Card B-1 Card B-1 Date MECHANICAL (Permit) OK except #'s Card B-1 Date Card B-1 Dater 36. C. Ducts Insulation & Support 3 nt Fan, Exhaust above insulation 64. 38' Condensate Drain & Overflow, Size & Grade 65. 39. urnace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection Date Date Card B-1 Date Card B-1 Date Card B-1 Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 49t Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. eplace Ties or Type A Flue -Fireplace Throat Clearance V. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles drm. Windows or Exiting Doors -Sill Fjt. Dimensions Garage Fire Protection Framin -C nn" 5�; Property Line Firewall & Openings- .54. penings .54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits airs; Width -Headroom -Rise -Run -Landing -Fire Protection Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57.ding-Na' ' g Veneer 5Y. St cc esh-Drip Screed -Fd. Vents-Underflr. Access i 59. Ggazino Are lass Protection-Skvliahts-Plastic Walls; ding -Bolts InteAr/Exterlor Wall Panels V. Insulation -Wal 63. Infiltration -Wal Date 7 vY' Card B-1 Date 1")1,9 - Card B-1 Ile Date /Of Card B-1 Date Card B-1 Dater f FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. - 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door; Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes _ 83. ollowin Instld./Drive O Yes D No/Walks O Yes ❑ No/Planters O Yes O No Wr . Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Prote0on 91. Correc!Ks from Previous Insp ion 92. Gas $6st-Meters Tagged, G , Ele c 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date q1Z Card B-1 Date Card B-1 Date�Card B-1 Date Card B-1 nCard Date B-1 Date Card B-1 Comments at Final: �g r) /��-� 6y County of Butte Oroville, California GENERAL CLAIM CLAIMANT: Cher Yang and Seng Vang ADDRESS: 60 Nelson Avenue #4 CITY & STATE: Oroville, CA 95965 nATF OP CI AIM- 07/08104 SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM DESCRIBE FULLY TO AVOID DELA AMOUNT Refund Claim - See attached calculation sheet APN: 030-110-083 Permit No:. BP041336 PAID RETAINED REFUND Development Services $ 659.88 $ 219.96 $ 439.92 THERM DRNG $ 510.00 $ - $ 510.00 SMIP $ 7.74 $ - $ 7.74 SHR $ 305.01 $ - $ 305.01 TUA $ 540.01 $ - $ 540.01 TOTAL $ 2,022.64 $ 219.96 $ 1,802.68 ::::::::: 101001 DVLPMNT SVC 440-001 4210500 $ 439.92 1011822 THERM DRNG 1800 280 $ 510.00 1011430 SMIP 1001 280 $ 7.74 1011811 SHR 1800 280 $ 305.01 1011816 TUA 1800 280 $ 540.01 TOTAL $ 1,802.68 $ 1,802.68 i, cne unuersigneu, ueciare unser penny or perjury mac me services or amcies claimed nave been pertormed or delivered, aid that this claim is we and correct as stated. n Dated this i day of �" , 2004, at 6/1 7,^'1 '� , Calif. SIC -,VA"' Signature of Gaimant I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specked above have been performed or delivered and that there is a Budget Appropriation or Specific Board Approval (Check one}fe a same. Dated this day of C�2004, at Oroville Dept SEE Exp. Code BREAKDOWN Code PAYABLE FROM FUND DO NOT WRITE BELOW THIS LINE -AUDITOR'S USE ONLY DEPT & SUB PROD I SUB. OBJ I CLAIM N0. I INV N0. I INV. DATE I ENCUMB. GROSS AMT. AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 l l l i l l 111 l 1111 l 1111111111 l 11111 I I 200-0053772 Recorded I REC FEE 7.00 Official Records 1 COPIES 2.00 CountyBUTTEOf I CANDACE J. GRUBBS 1 Recorder I ROSEMARY DICKSON I Assistant I Jason 02:36PM 02 -Sep -2004 I Page 1 of 1 AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this. property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, Stdie of California, described as follows: PARCEL 4 AS SHOWN ON THAT CERTAIN PARCEL MAP OF A PORTION OF LOTS 1 AND 3 OF BLOCK 111 OF THERMALITO, WHICH MAP WAS FILED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON AUGUST 15,1977 IN BOOK 62 OF MAPS, AT PAGES 49 AND 50. EXCEPTING THEREFROM ANY PORTION THEROF, LYING WITHIN THE EXTERIOR.LIMITS OF PARCEL 1 AS DESCRIBED IN DEED RECORDED AUGUST 22, 1979 IN BOOK 2434 OF OFFICIAL RECORDS, AT PAGE 671, RECORDS OF BUTTE COUNTY, CALIFORNIA. ALSO EXCEPTING THEREFROM ALL OIL, GAS, MINERALS AND RIGHTS AND PRIVILEGES PERTAINING THERETO AS RESERVE IN DEED FROM SCRAMENTO NORTHERN RAILWAY, A CORPORATION, RECORDED JUNE 11, 1964 IN BOOK 1318 OF OFFICIAL RECORDS, AT PAGE 582, RECORDS OF BUTTE COUNTY, CALIFORNIA. AP NO. 030-110-083 Date -7/2el2ooY PROPERTY OWNERS: State of California County of &71'C On L'/�ilZ �Y•s�n/(, /,W.V SFi✓G VAVZ, s✓:'0,7e kgs 501-15 �• <�:s S���i/a til �- before me, personally appeared y:stiG 4W,1D seN,� ✓mNG, .VUjpavP 9,�D personally known to me (or proved to me on the basis of satisfactoryevidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand, and official seal. Signature Seal: P�..A Oi rhF JANIE CLARK 0':U Comm. #1312686 NOTARY PUBLIC CALIFORNIA 0 BUTTE COUNTY .l MY C0r1 M'SsIO-ExPlres JUI, 9, 2005 SG 4 1 BUTTE COUNTY DEPARTMENT OF, DEVELOPMENT SERVICES., BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.neAdds PERMIT NO. BP042227 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 09/21/2004 APN:' 030-110-083-000 the Business and Professions Code, and my license is in full force and effect. License Class: 14e License Number: Site Address: 1663 GRAND AVE ORO Map Index: Date: Contractor. Description: NSF (1568) GAR(442)COV(346) / OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner' VANG, SEIVG 81 YANG CHER ' permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 60 NELSON AVE APT 4 s signed statement that he or she is licensed pursuant to the provisions of OROVILLE, CA the Contractor's State License Law (Chapter 9 commencing with Section 95965 f 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, wills do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: WORLD F M CONSTRUCTION CO ; Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for 1617 71ST AVENUE sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of SACRAMENTO,CA 95832 l proving that he or she did not build or improve for the purpose of (916) 870-2344 sale.). ❑ I, as owner of the property, am exclusively, contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. •The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor:'WORLD F M CONSTRUCTION CO and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Business and Professions Code 1617 71ST AVENUE Date: Owner: ' SACRAMENTO,CA 95832 (916) 870-2344 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for License #: 740981 workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as Architect: required by Section 3700 the Labor Code, for the performance of Engineer: the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 2446 S.F. Policy#: I certify that in the performance of the work for which this permit is Valuation: $123,914.00 issued, I shall not employ any person in any manner so as to Census Code: become subject to the workers' compensation laws of California, and agree that if I should ..become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: 0 Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor r i� iO7 Oo3 Z (o'Q-? , 3Gl -7 - 77- �¢ code, interest, and attorney's fees. ,CONSTRUCTION LENDING AGENCY This permit i hereby issued under the applicable provisions of the Butte County Code andlor I hereby affirm that there is a construction lending agency for the Resolution to do work indicated above for which fees have been paid. performance of the work fohich thhs permit is issued (Sec 3097 Civ.`�� q, �Q • e Name:. /� 1 1i9� cr �Q By: +� Date: PER 1 EXPIRES ON: r • 0 5 a Address:�LOQ1.�i/� (Date)1 ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code; which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health 8 Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any officiaZformor ument of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: i s'�✓C//a}�S /�- Signature: Date: ❑ Owner Contractor ❑ Agent for Owner 0 Agent for Contractor F, 0 0 a' .0 l O1 s6 Q� BUTTE COUNTY �1 P � J ' " ' PERMIT 0 DEPARTMENT OF DEVELOPMENT SERVICES NO. 0 BUILDING PERMIT APPLICATION 0 AND SUBMITTAL REQUIREMENTS 0 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 BPd49 0 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION BIN "PLEASE PRINT CLEARLY" ARCHITECT/ENGINEER OWNER Last Name � first Name ! AVb"— Address o AA -e-, City 42 �! �� State Zip 6 Phon ,O .r Fax E-mail s ARCHITECT/ENGINEER CONTRACTOR Name &-b-gx.aerxf �vig� Co• �uyq . i Address a %,4asA�i4 iNJx� Av '7>r - City G3^ State Zip 2 Phone(5F`V g2® -23 E-mail 40 Lic woqg J Clas ARCHITECT/ENGINEER Name /p/ "_ /V �`. 4C5eXgjCyi^a 'Ti Address�S//9 /y V15 1'4u2, CityC-r�ry State Zp Phon&/6 No E-mail State License Number v 'G APPLICANT SIGNATURE X For office use only: APPLICANT NAME Name cJf4 Address -763 ® i4rL>N9� iv t �r- city No State, Zi Subdivision Name �h�✓�� Page s Phon -23Zi F /46gA—o`3 E-mail APPLICANT SIGNATURE X For office use only: Zoning Property Address J (o Vz Flood Zone Cross Street !� 71 S T_ SRA Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: LOCATION AP# OT 3 Property Address J (o Vz (E� Cross Street !� 71 S T_ WORKER'S COMPENSATION Policy Number 1L Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: t7 U Sq. Footage �"dS%16L2 ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a pen -nit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the persod4who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: Amount 242 .33 Bldg 000 — SRA Receipt #: 4-07 o 0 3 3 (O • Sheriff OVER FOR SUBMITTAL REQUIREMENTS L K:\FORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 1 of 2 Date: �►, s7, 12-39 SMIP Other 3014.7 8 Total REV 6-16-04 SUBMITTAL REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply fora permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE L B AND ININ% y Residential, New, Remodels, Additions, and Accessory Structures: ,or" 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! .ET 2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPER! OR 3 Sets Engineered plans (if required) with wet signature on plans AND 2 sets of stamped wed calculations. -ef 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ,Y 4. Letter from Engineer or Architect for truss design review. ,4�r 5. 2 Energy compliance design and supporting documentation. (Note: Not required for additions to mobile or modular homes) ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Detached Accessory Building Form, filled out by the property owner (if required). ❑ 8. Sanitation and site plan approval from the Environmental Health Department. ❑ 9. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer. Mobile, Manufactured, or Modular Homes: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ 4. 2 Floor plans. ❑ 5. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation and site plan approval from the Environmental Health Department. ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). Commercial, New, Additions and Remodels: ❑ 1. 4 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations, with code analysis. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation (if required). ❑ 6. - 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Statement of Intent for Non -heated and A/C (if required). ❑ 8. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the en ' eer ❑ 9. Letter of intent. ❑ 10. Hazardous Material Form. ❑ 11. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530) 538-7541. OVER FOR BUILDING PERMIT APPLICATION KAFORMSSUILDING FORMS\6IdgAPPISubRgmts.doc Page 2 of 2 REV 6-16-04 �aG4�'f� v. i ��, �Yly a..n �,,�., � . , r.�-...,,'- ..V.. . r4-..-r-:«-:^v' . �`.A1 _. -•._ �'�..,-. i �,! COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 Coun_ty Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET s 030 • r r o oS 3 OWNER: N 2-- ? ASSESSOR PARCEL NUMBER GOV Pea R- /3�4} Proposed Building Use: I' ! 5 F t 5tO), Air 6AP- �'4 2� Counter Technician:I / Date: 7.-) 7 04 - It ms required in ordef�to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. 1. Site plans'., 3 or 4 sets, signed by the preparer of the plans. . 2. Complete p ans,Aor 4 sets, signed by the preparer of the plans. ❑ 3. Engineered planV3 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. 41 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. I ' 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd.plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs f ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ' 14. Hazardous Material Form 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. ❑ 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers................:........................................................................... 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........ 20. Erosion Control Plan Required...:.................................................................... ........ 21. Fees as shown on the attached Schedule of Fees Due Sheet ................... ❑ 22. City of Chico Plumbing permit........................................................................ 60 23. California Department of Fores ry plan approval ❑ paid. Sent by: ........... 24. Planning approval (A) Use: (B)Parking: (C) Parcel Check: G ❑� 25. Contact Land Development about _ Improvements, _ Drainage ......................... 26. NPDES Form ....................................................................... 27. Encroachment Permit for driveway from the Public Works ❑ 28. Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... ❑ 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ 32. Letter of Signature authorization......................................:.........q 33. Recorded copy of Agricultural Acknowledgment Statement..............1../.. 34. Manufactured home utility clearance............................................................... ❑ -35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction......................................................................................... �-. 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ '38. Other: P LEEP #=r2or.> (iNEQ 0LLI-T0 1aioie-A.-rtn. r D1:5 ❑ 39. Other: When issued Telephone' -11(6- 870. 0344- and hold for pickup. I have been informed of the ab litems and requirements for obtaining a building permit. yApplicant: Date: 1. Index permit applicatiowfr the i s. u Plan Check Letter 2. Additional items re fired Contractor, designer, owner, was advi ed o ve dat y ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: ' Plans approved by: I AnA A Date Structural reviewed Date: Structural approved by: Ll� Date: Note transfer by: Date: Yellow: Building Division COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541 SCHEDULE OF RECEIPT OF FEES OWNER e� �2 A.P. # 030 I 1 O • 083 PROPROSED BUILDING USE &ISF /156$� ATT &Ae ( 442) DATE 7.4- cT Go✓ Poo 34(0 RECEIPT # DATE REC. 1. BUILDING PERMIT FEES --- Balance Due ..................... $ --- Additional Fees Due........... $ --- Revised Plan Checking Fee.... $ ' I 2. SCHOOL DISTRICT FEES OQp ✓t tet_ t<t r, (paid at School District Office) (form available r lan C eck) A - SHERIFF FEES (paid at Building Division Residential............ X $360.00 =$ 3ro0 . X7003 7' X04" Units 1 Commercial (sq. ftg.)..... X $0.03 = $ Sq.Ftg. 4. URBAN AREA FEES (paid at Building Division) Residential (per unit)..... X = $ # Units Amt. Commercial (Sq. Ftg.).... X = $ Sq. Fig. Amt. 5. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) La 7. SRA FIRE INSPECTION AND PLAN CHECK FEE $89.00 (paid at Building Division) 8. WATER TENDER FEES BATTALION # $200.00 (paid at Building Division) 9. NORTH CHICO SPECIFIC PLAN (paid at Building Division) Residential Zone X = $ Zone # Units Amt. Commercial (sq. ftg.) ......... x = $ Sq. Fig. Amt. 10. OTHER At time of permit application, I was adv' ed the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan the ng cess. APPLICANT 1/ DATE Pursuant to Government Co a Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003) tte County Department of Development Services NE CHRISTOPHER, DIRECTOR LP2A Scott Rutherford (530) 538-7160 srutherford cDbu8ecounty.net Plans Transmittal For Review Per Contract 7/28/2004 Applicant: Cher, Yang Permit 04-2227 Project Type: NSF/Gaya a/Cov APN: 030-110-083 100% 70% Plan Check Fees $ 1,056.96 $ 739.87 $ 1,056.96 $ 739.87 LP2A Fee $ 739.87 Copies Attached: Qty Chk Application Site Plan Review FEMA Elevation Certificate Building Plans Truss Calculations Energy Calculations Structural Calculations Residential Plan Review Guide Residential Construction Requirements Other Other 7 County Center Drive Oroville, CA 95965 N (530) 538.7601 Telephone (530) 538.7785 Facsimile N N TO: ' FROM: 1 SUBJECT: O � DATE: LP2A Scott Rutherford (530) 538-7160 srutherford cDbu8ecounty.net Plans Transmittal For Review Per Contract 7/28/2004 Applicant: Cher, Yang Permit 04-2227 Project Type: NSF/Gaya a/Cov APN: 030-110-083 100% 70% Plan Check Fees $ 1,056.96 $ 739.87 $ 1,056.96 $ 739.87 LP2A Fee $ 739.87 Copies Attached: Qty Chk Application Site Plan Review FEMA Elevation Certificate Building Plans Truss Calculations Energy Calculations Structural Calculations Residential Plan Review Guide Residential Construction Requirements Other Other AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 IIIIlIIIIIIIIIlIIIit111111IIIIIIII 21fb04-053772 Recorded I REC FEE 7.00 Official Records I COPIES 2.00 CoBUTTE ty Df I CANDACE J. GRUBBS I Recorder I ROSEMARY DICKSON I Assistant I Jason 02:36PM 02-S.ep-2004 I Page 1 of 1 AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this. property may.!?e subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, Stdie of California, described as follows: PARCEL 4 AS SHOWN ON THAT CERTAIN PARCEL MAP OF A PORTION OF LOTS 1 AND 3 OF BLOCK 111 OF THERMALITO, WHICH MAP WAS FILED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON AUGUST 15,1977 IN BOOK 62 OF MAPS, AT PAGES 49 AND 50. EXCEPTING THEREFROM ANY PORTION THEROF, LYING WITHIN THE EXTERIOR.LIMITS OF PARCEL 1 AS DESCRIBED IN DEED RECORDED AUGUST 22, 1979 IN BOOK 2434 OF OFFICIAL RECORDS, AT PAGE 671, RECORDS OF BUTTE COUNTY, CALIFORNIA. ALSO EXCEPTING THEREFROM ALL OIL, GAS, MINERALS AND RIGHTS AND PRIVILEGES PERTAINING THERETO AS RESERVE IN DEED FROM SCRAMENTO NORTHERN RAILWAY, A CORPORATION, RECORDED JUNE 11, 1964 IN BOOK 1318 OF OFFICIAL RECORDS, AT PAGE 582, RECORDS OF BUTTE COUNTY, CALIFORNIA. AP NO. 030-110-083 Date 7/2p/2cvy' PROPERTY OWNERS: L'/�%iZ ✓.s�i,/y :�.✓v S�.✓G ✓a.✓G f�Us(j<�iJsv .H.n/,7 C✓ire ,g f Jvi.✓� t :lc4f S e v5�UG 1/1 C-� State of California County of &7/' On 7/?Z/7ooy before me personally appeared_ y,�>aG f d.4.ve 9,✓D personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my b and official seal. Signaturea o�. ,�� Seal: JANIE CLARK a; Comm. #1312686 A.P. #O //O� P NOTARY PUBLIC CALIFORNIA 0— BUTTE COUNTY -4 My CommissIOP.Explres Jul, 9, 2005 6 SG THERMALITO IRRIGATION DISTRICT �T 410 GRAND AVENUE 1\ � 2259 OROVILLE, CALIFORNIA 95965 TELEPHONE: (916) 533-0740 FAX: (916) 533-9243 SEWER SERVICE APPLICATION AND CONNECTION PERMIT Service Address: 1684 Grand Avenue Owner's Name: Cher & Seng Yang Date: July 22, 2004 Address: 60 Nelson Avenue, Apt. 4 Acct. No.: 300305 Oroville, CA 95965 A.P.No.: 030-110-083 Phone: 530-533-3827 New Unit: 1 Applicant/Agent: Adding Units: Address: Fees: Phone: Permit: $ 50 00 T.I.D.: 1705 00 Preliminary Review By: Date: Ext. Fees: ' Remarks:' CONNECTION FEES WILL BE 'THOSE APPLICABLE AT SC -OR: 1000 00 TIME Or CONNECTION TO THE SEWER COLLECTOR SYSTEM. Lateral: 75 00 CLEAN OUT UP TO GRADE, REQUIRED AT PROPERTY LINE. Other:Encnr 66 00 SEWER CHECK VALVE REQUIRED. SEWER P-EZMIT-FEE INCLUDES ONE CONSTRUCTION INSPECTION ONLY. INSPECTION WILL BETotal Fees: 2896 00 BILLED $50.00. Amount Paid: 2896 00 Collected By: cm- Finaled By: Date: Location: r1 nIII 1Ul _ 11 lil Size Line: ur �U u f 0 i Signature of Owner/Agent: /V2 MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON COMPLETION Date Billed: Computer: Paid SC -OR: A.P. File: (R.F.C.) Blue Book: Paid SC -OR: Meter Book: (S/C HG's) Rev. 6/85 0 Department of- Public Works ° 7 County Center Drive C o u n t y o f B u t t e 0 0 J. Michael Crump, Director LAND DEVELOPMENT DIVISION O Storm Water Management Program Oro M. CA 95965 AI 9 �1 W O (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement [LESS THAN 1 ACRE1 Project Description: Z Z -- Project Location and/or Parcel Number: By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project that disturbs one acre or more of land may result in revocation of grading and/or other permits or other sanctions provi�PA 1,�� 1n.�, Signed: Title: Date: Less than 1 Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program Revised 5/12/04 BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) Srdtool District ` Building Department No. �✓ • � 1 � A.P. Number U• ' U� Jurisd n• City jCounty Property Owner Property Location/Address Subdivision Residential Development Q Q No of Living Mobile Home Units Installation Commercial/Industrial Building Department Sq. Footage (Group R) Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) O Sq. Footage New Addition (Including nor Roofed as) eeA bve ?a Date � f District Identification* No. 0!5 0® 7 6 �Iby l' VLy` i �^ kjGt,,K School District certifies that v cy-tR r- x k-v\t— (Applicant) (Street Address) (Phone Number) (City) (State) (Zip Code) has complied with the requirements of Resolution No. by payment of $,, representing 1 square feet. 2926 i .' FULL MRIGATION = School District Representative jDate Paid by Check # Remarks: \30Y Id Fm Cors-V'Ch oy\ Notice: You may protest the Imposition of the fess Identified above by submitting a written protest to the District, In compiler" with Governmwd Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written protest will'prohiblt you from challenging the Imposition of the hes In any court action. K, subsequent to the School District Representative signing this Butte County Schools Impact Fes CertlNation Fom% the School Dietrkt Is , notMed by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA] thle protect may be sublet to additional school hes to fully mltigals.No Impact on the school distrldls schools. White (applicant), Yellow (building department), Pink (school district) testomi.rds (10/03)dmm IN SITE PLAN REVIEW APPLICATION Date: AP# 0 370 r //6 f% 6 5 Permit Number (if applicable) Q q" 2 2 2 -7 Bin Number 4-- 2; APPLICANT INFORMATION Owners Name: Owners Address: Telephone No.: Situs Address: Proposed Use: Residential New Single Family Residential ❑ Single Family Addition ❑ Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling ❑ Temporary Mobile Home (Aunt Minnie) ❑ Temporary -Travel -Trailer. ❑ Multi -family Non-residential ❑ New Commercial ❑ Commercial Addition ❑ New Industrial ❑ Industrial Addition Other ❑ Septic ❑ Agricultural Exempt Building ❑ Other: Brief Explanation (if necessary): Parcel Size: ❑ Single Family Remodel ❑commercial Remodel ❑ Industrial Remodel ❑ Well ❑ Agricultural Buffer Form ❑ ,Applicable ❑ .N/A DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) Approved 0 Conditionally Approved ❑ Resolve Problems Prior to Approval Site n Stampe pproved By Date Z40tf Page 1 of 5 ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: ❑ Snow Load Area: ❑ Land Conservation Act Minimum Acreage: ❑Verify residence can be built per contract ❑ Nitrate Action Plan (See Environmental Health for standards) ❑ Watershed Protection Overlay Zone (See attached standards and requirements) ❑ Expansive Soils (Test for expansive soils and if verified proper foundation design required) ❑ SRA - (CDF to determine specific requirements) ❑ 100 -Year Flood Plain: (See attached) • Flood Zone: 4 • Flood Panel No.: 0-7- O f Index Date: ❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit ❑ Minor Variance ❑ Variance -------=---------------------------------------------------------------------------------------------------------------------------- ❑ Detached Building• Use Form ❑ Encroachment Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning:/ID; Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 Zoning Code Streets .& Highways Fire Prevention Subdivision Map Front Side ' Side Street Rear f v Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 Applicable Development Fees: Standard Fees ❑ Fire ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Drainage Area ❑ Thermalito Urban Area ❑ Other Subdivision Map Special Fees ❑ Water Tender ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) Amount Formula * Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of the building permit. Parcel Created By ❑ Deeds: Date of Creation: Legal Access Provided: ❑ No ❑ Yes Deed of Reference: Legal Access Required ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name: Complies with County 't�andxds or Deed Cr ation: No Yes Comments: Xvvet a , jrw �% fr6 G �w a -e.M-f7 ❑ Parcel Deemed to be legal ❑ Verify Legal Parcel ❑ Verify Legal Access ❑ Provide Deed of Creation ❑ Obtain a Certificate of Compliance ❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment ❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23). ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements Page 3 of 5 t e e kv�wf t# -5-,0 " 1 ❑ Subdivision Map/Parcel Map: Map Date of Recording: - f (f Lot: ❑ Use Permit/Minor Use Permit Permit Number: Book: 41 2 Page: �9 Date of Approval: Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 ❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan must be prepared by a registered civil engineer or other qualified professional and be submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate Battalion Water Tender Fund may be required. ❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated with residential 'development. Approved dust control measures are found in the fugitive dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible for road maintenance, and stop sign maintenance. 0 U Page 4of5 0 0 0 Summary of Specific Requirements: This information provided" in this summary is based on the application information and on the best available data at the time of review. CALarrys\Building Permit Site Plan Reviewl.doc Page 5 of 5 Received BUTTE COUNTY gEp g 2004 9 � AGRICULTURAL BUFFER NOTIFICATION AND/OR 619j0UL7����� UNUSUAL CIRCUMSTANCES REQUEST Butte County requires a 300 foot buffer between neighboring agricultural operations and a residence. This dimension is based on environmental assessments and studies. The Agricultural Commissioner may identify unusual circumstances where the 300 foot buffer cannot be met on existing parcels. This exception is not available for lots being created, divided or subdivided. Owner or Authorized Agent must complete the following and return with the required site plan to: Development Services Department, 7 County Center Drive, Oroville, CA (55330) 538-7601 Name: Phone: t A _ Mailing Address: (2 r �--- E -Mail address Assessor's Parcel Number: 4ZO Reason you believe you qualify for the unusual circumstances exception: �imensia(ls oy �Vi ; e)*;Tinq 10 mukPe Che 3W fit gq' Ter To W1. AA XTP VaPSC ,-thG lot fS 2,qb rp(?T An exceptional or extraordinary condition where the existing lot size or shape or an existing improvement (well, septic systems, structureLbmit does at-allew-fer-th ndard condition of a 300 -foot buffer zone. SITE PLAN REQUIREMENT: 4 copies with this forRefer to the Site Plan Submittettfer-s ec' ements ... :............................................................................................................................................... Internal Dept. Contact Info: ❑ Env. Health ❑ Planning ❑ Building ❑ Other Contact Person: Phone: FORWARD THIS FORM TO LARRY IN DEVELOPMENT SERVICES FOR PROCESSING ......................................................................................................................................................................................... For Agricultural Commissioner office use only: (to be completed after submittal ) DISCRETIONARY PERMITS (Planning) MINISTERIAL PERMITS(Building ❑ Exception Recommended Exception Granted with the ❑ Exception NOT Recommended following conditions: Reason/Conditions/Specific setbacks from adjacent agricultural operations: �rz Pps l ('QS wA ��w-� �L r3 irao� I�ssible . Agricultural Department Signature: Date: oq t YAC 7/1/03 V1611411 T MAr t� iyTy COU26 Y . V1611411 T MAr t� C� Cry-71 ; way ire t ac's 'A, � -.'�+ •. �;�'^ �"�' J : y��' : ^ � „� �,� � t. J R � � �.1 �.�� � 1 .-M y ,. ._•off 4 14 Jj Ol r ,r 030-110-08 A-R,. c'__-LDR 7�l�%�'' �.;,=:err"i�.. ,�' +i.;t w• '�'�:"�It• r .1., tr rr�#'' !Mw�+:,�«,, —�.1 �,� �, .,..�. � �,� �,•��,r�� .,A ,�"�n.*,t,; #+ ��'�t i�4.9,7 � !w�hy�''r �» 1", �^A�, �: e*"�Yg""1M .1�! !A `'`)s�., "Y.� zt�' r$_ . , i +t `•,• '�- ' •y��'S``v'!!+ w wrt � �' �p �ti u� A � � tis �} �r�r•� � ,.,fir '�. + � � �rwi."�d�F4'h .'+,�r'�'�!r . �f' a 3a,�9�,#31C$►�!".,�iyl•�I,�,`7�"'''�'#�!!�' •-,;� ` -r -W t.4' +!? ih 104.yo( QF " ' �?► t# it ♦} .: ,+ CD ! to*, v»b it t + 1d k+ ��S � 1 T � 4 l� !� A� `t !+ ��� + � � � ������� �9q�h/+1A� RYa�.�D � 1R�s"16 M+� �'♦ i I � It 04 ate!` , �. .�.A- � v-r - � ' ►•Thi. ,�. ! y�r,.l�• .•v, i, Jl. e✓ t�'.. - �►=^1 �•�`�.``'`...i+�.�,-. ..-�........... .., .. - QLP (2 o [� LBUTTE COUNTY as ?'D $�RtME OF DEVELOPMENT \/"`� BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS Q� V 24 , SPECT'ION#: OROVILLE: (530) 538-7636 - CHICO: (530) 891-2834 �y OFFICE #: 530 538-7541 n 6/ A FEE WILL BE REQUIRED AT TIME OF APPLICATION (f� \ "PLEASE PRINT CLEARLY" 0' W C"A(- ARCHITECTIENGINEER Name Addr,//9 City State Z� c . Phonte�/6l F ?fid, lap -,90;6 E-mail State License Number Subdivision Name Map Book to, APPLICANT NAME Name iJf�• tll� Address ,7630 /47/LH/Z 2✓.9+;>}- Citi+State Crpp e Z� c . Phon 4 '/ F/� E-mafl APPLICANT SIGNATURE X For office use only: Zoning Flood Zone SRA I Yes I No Occ. Type Const Subdivision Name Map Book I Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS ^ PERMIT NO. BPa4!!3 BINA . I' ' LOCATION AP# -!/�-off 3 Property tAddress City Cross Street /-O •rt, s T_ WORKER'S COMPENSATION Policy Number .[L Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address • Description or Scope of Work: 1V�4,1 Sq. Footage NSFUDS'W 4,Q ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not reftmdable. Received by: Amount 2ro42•3q Bldg do ki — SRA Receipt #: 4-070'=>5 3 �10 - Sheriff 12.3 9 SMTP Date:Other 7• 3014.78 Total APN: 030-110-083 AV. NORTH PROPOSED PLOT PLAN 1687 GRAND AVENUE OROVILLE, CA 95965 scuE 1•=20'-o' ea•rWae,n, a,•nacrm World FM Construction Co. a,q •sr-a,m W / Mw�onr lum 1-1 2m ma o0 oq ,... MO. AS �u•oivm n na sr� v cmm • No UX& aoss•er MM AM APMWA t to Tm now=. BUILDING CODE DATA a•L AM a•a . , Ua, nua. eanaiero, me Qat. . FIK Mr. DRAWING SHEET INDEX s w in MCFAR •• nav ,iwe s r,m•-w�• a raw�rro•.n,w s rum�mr ocuss a rwivaw oir�noa, • atm cuv�noa, Prepared By: Butte County Department of Development Services YVONNE CHRISTOPHER, DIRECTOR 7 County Center Drive Oroville, CA 95565 (530) 538-7601 Telephone (530) 538-7785 Facsimile ADMINISTRATION * BUILDING * GIS * PLANNING July 8; 2004 Cher Yang, Seng Vang 60 Nelson Avenue #4 Oroville, CA 95965 RE: Permit No. BP04-1336. APN#030-11.0-083 Owner: same On 5/11/2004, a deposit was made in the amount of $2,022.64, of which $219.96 -was retained. The remaining fees will be reimbursed to you. Please sign, date, and return the enclosed claim form to this office. Once we receive the claim form, we will then process your refund in the amount of $1,802.68. Should you have any questions, please contact this office Monday through Friday, 8:00 a.m. to 4:00 p.m., at 538-6869. Sincerely; Diane Lewellen , OA III Administrative Division enclosure BP04-1336.1tr County of Butte Oroville, California GENERAL CLAIM CLAIMANT: Cher Yang and Seng Vang ADDRESS: 60 Nelson Avenue #4 CITY & STATE: Oroville, CA 95965 nATI: nF rl AIM- f17/()R/()4 SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM DESCRIBE FULLY TO AVOID DELA AMOUNT Refund Claim - See attached calculation sheet APN: 030-110-083 Permit No: BPO41336 PAID RETAINED REFUND Development Services $ 659.88 $ 219.96 $ 439.92 THERM DRNG $ 510.00 $ - $ 510.00 SMIP $ 7.74 $ - $ 7.74 SHR $ 305.01 $ - $ 305.01 ITU A $ 540.01 $ - $ 540.01 TOTAL $ 2,022.64 $ 219.96 $ 1,802.68 ............... .............. ............... ... ...... .::....:.::.:.:. :: }»:::::: »: .. � . . . . . ............................................................ ............................... ............................................................ .............. Y1A0 .,:: ............................ ' . ..N ::?:4]VIoX11 .............. .............. : 101001 DVLPMNT SVC 440-001 4210500 $ 439.92 1011822 THERM DRNG 1800 280 $ 510.00 1011430 SMIP 1001 280 $ 7.74 1011811 SHR 1800 280 $ 305.01 1011816 TUA 1800 280 $ 540.01 TOTAL $ 1,802.68 $ 1,802.68 I, the undersigned, declare under penalty of perf'ury that the services or articles claimed have been performed or delivered, and that this claim is we and correct as stated. Dated this day of , 2004, at Calif. Signature of Claimant I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or delivered and that there is a Budget Appropriation or Specific Board Approval (Check one) for the same. Dated this day of 2004, at Oroville Calif. Department Head or Authorized Deputy Dept. SEE Exp. Code BREAKDOWN Code PAYABLE FROM FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY DEPT & SUB PROJ SUB. OBJ CLAIM NO. INV NO. INV. DATE ENCUMB. GROSS AMT. CLAIMANT: Cher Yang and Seng Vang ADDRESS: 60 Nelson Avenue #4 CITY & STATE: Oroville, CA 95965 DATE OF CLAIM: 05/14/04 030-110-083 -APN-- RECEIPT INFORMATION NUMBER: DATE: ISSUED TO: CHECK#: AMOUNT: PERMIT #: REFUNDS: 405853 05/1112004 Cher Yang and Cash $2.022.64 BP041336 Yes I me BLDG THRM DRNG AUD SUSP SHER DEV FEE THRM UREN Fund 0010 1800 1001 1800 1800 Dept 440-001 rHRM DRN( (SMTP) (SHR) (TUA) Accnt 4210500 280 280 280 280 Cash 101001 1011822 1011430 1011811 1011816 DETAIL PAID RETAIN REFUND BLDG Time 109.98 549.90 ........ . ......... ........ ........ ........ ........ ................ filming (from Plan Check) 0.50 54.99 54.9 -54.99:•:•:•:•:•:•:: ................ ........ ....... ................ ....... ...... Plan Check/Filing 000 219.96 1 219.961 2-19.96 Ins action 0.00 329.94 329.941 329.94 ................. BLDG FEES ................ ........ ....... ........ ........ ................ OTHER BLDG . . . . . . .... ....... 1TUA 54.99 54.99 0.00 0.00 . ........ •................ . ................ ........ ....... :SHR 54.99 54.99 0.00 0.00 ... ­ .......... REFUND PROCESS FEE 54.99 54.99 -54.99 -54.99':':':':':':':'::'•:':':•:•:•:• ......... ....... ........ ........ ................ ................ ........ ........ ........ ........ ................ ................ ........ ....... BUILDING TOTAL 659.88 219.96 439.92 439.92 ........ ................ ........ ........ ........ THERM DRNG 510.00 510.00 510.00 SMTP 7.74 7.74 7.74 ................ ........ ....... SHRR 305.011 1 305.011 305.01 TUA 540.011 1 540.01 1 540.01 $ 1,802.68 $ 439.92 $ 510.00 . . .... �7.74 $ 305.01 $ 540.01 APPROVAL CHECK: $1,802.68 Date Reviewed 05/17/2004 DIFFERENCE: $0.00 Michael Vielra (Should be blank) Building Manager Developm nt Services Monday May 17 2004 - -BUILDING DIVISION VPr1 n Counter Alice I Person Fund 10 (Bldg Permits) $659.8$: SRA Fees (Fire) $0.00 Payment Date5/11/2004 I SHR Fees (Sheriff) $305.01 Permit Number BP041336 I SMIP $7.74 Receipt Number 405853 I Copies/ Document Sales $0.00 'Check Number or Cash CASH I CUA (Chico Urban Area) $0.00 Parcel Number 030-110-083 I TUA (Therm. Urban Area) $540.01 Applicant VANG & YANG I Water Tender Btln West Chico Fire Station $0.00 - Received From SAME - Witness Fees $0.00 Total. Received$2;022. - 64-=I Recorders Fees (N.O.C)—$0.00 Thermalito Drainage $510.00 Total Fees To Collect $2,022.64 Oroville Area Traffic $0.00 Notes: NSF (Non Sufficient Funds) $0.00 Notice of Violation $0.00 NCSP Trails System $0.00 NCSP Roads/ Bridges $0.00 NCSP Storm Drainage $0.00 . NCSP Fire Station ( $0.00 NCSP. Parks Type $0.00 y Value $0.00 National Pollutant Discharge Elimination System (NPDES) Phase II .Construction Storm Water Permit and Storm mTHr Pollution Prevention Plan (SWPPP) Acknowledgement rLESS Project Title: It? 7 h -V i By signing below, I, the project owner/owner's agent, certify that I am aware that a construction project that disturbs 1 acre or more of land requires a Construction Storm Water Permit from the State Water Resources Control Board and that it is my responsibility to submit a Notice of Intent (N.O.I.), a Storm Water Pollution Prevention Plan (SWPPP), and a check for $700.00 made payable to the State Water Resources Control Board to obtain such a permit if my project disturbs 1 acre or more of land. I, further, certify that this project will not disturb 1 acre or more of land. I am aware that submitting false and/or inaccurate information may result in revocation of grading and/or other permits or other sanctions provided by law. • Signed: Title: Date: Com✓ 424- - Butte County Department of Development Services Building Division 7 County Center Drive Oroville, CA 95965 (530) 538-7541 REFUND REQUEST APPLICATION REFUND POLICY - Butte County Code 3-41(t) 1. Refunds can only be made upon written request by the person who paid the fees, whose name is on the receipt issued for the fees paid. Any refund checks will be made payable to the name on the receipt. 2. The request must be made within two years from the date of fee payments on permits not issued, and two years from the date of permit issuance for permits issued -if no construction work has been done. 3. Filing fees and plan check fees for work plans checked are not refundable. 4. Fees paid to other County Departments are not covered by this claim. INSTRUCTIONS: Submit this application to Development Services for determination of refundable fees. A claim will be generated for any fees to be refunded and sent to the address below for signature (by the person whose name is on the receipt) and return to Development Services for payment processing. CLAIMANT'S NAME: L - MAILING ADDRESS. PHONE: (53U) x233 5 ASSESSOR'S PARCEL NO.: 2 3 .Q.. 11. 0' D. 1 5 [Please use one claim form per permit.] BLDG PERMIT NO.: Receipt No. 1 Receipt No. 2 Receipt No. 3 RECEIPT NO.: RECEIPT DATE RECEIPT AMOUNT: _ tyl cp'stk REASON FOR REFUND REQUEST: No Lo" Inas IXW dbtkV o1 TU 51111 �t -7y [� _ t Check those fees which you wish to have considered for refund: []Building Permit Fees Sheriff Fees SRA Fees (CDF Fire Planning) V%. 40 W =Other (specify): Plans for cancelled permits will be disposed of within 10 working days upon submission of a Q Request for Refund. If you want the plans, you may ick them up prior to that time. Signature Date K:/Forms/Refund Application 082203 ' REFUND CALCULATION SHEET CLAIMANT: ADDRESS: CITY & STATE: DATE OF CLAIM: Cher Yang and Seng 60 Nelson Avenue #4 Oroville, CA 95965 - 05/14/04 Vang APN: 030-110-083 NUMBER: DATE: ISSUED TO: CHECK #: AMOUNT: PERMIT #: PRIOR REFUNDS: FEES VERIFIED ` RECEIPT INFORMATION 405853 5/11/2004 Cher Yang and Seng Van Cash $2,022.64 BP041336 i Yes No Yes No Yes No X X REFUND BREAKDOWN DETAIL PAID RETAIN Title Fund Dept Accnt Cash REFUND BLDG 0010 440-001 4210500 101001- THRM DRNG , 1800 (THRM DRNG) 280 1011822 AUD SUSP 1001 (SMTP) 280 1011430 SHER DEV FEE 1800 (SHR) 280 1011811 THRM URBN 1800 (TUA) . 280 1011816 BLDG - Time 109.98 1549.90 :::::::::::::::::::....... :::::::::::::: ......................... ::::::::::::::::::::::: .............. ::::: :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: .......................... .............. ::::::::::::: .......................... .............. ........................................ .............. ::::::::::::: ::::::::::.................. ............................ ::::: :::::::::::::: ............................ ............................ ............................ :::::::::::::::::::.:: ............................. :::::::::::::::::::::::::::.:: ::: .............................. ::::::::::::: ............................. ::::::::::::::::::: ......:...... ............. ::::; ::;: ............. ............. ............. Filingfrom Plan Check 0.50 54.99 54.99 -54.99 -54.99 Plan Check/Filing0.00 219.96 .219.96 219.96 Inspection 0.00 329.94 329.94 329.94 BLDG FEES OTHER BLDG TUA 54.99 54.99 0.00 0.00 SHR 54.99 54.99 0.00 ; 0.00 REFUND PROCESS FEE 54.99 54.99 -54.99 54.99 BUILDING TOTAL 659.88 219.96 439.92 439.92 THERM DRNG i .510.00 510.00 510.00 ............ ............................. SMIP 7.74 7.74 SHR 305.01 305.01 305.01 ............. TUA 540.01 540.01 540.01 $ 2,022.64 $ 219.96 $ 1,802.68 $ 439.92 $ 510.00 $ 7.74 $ 305.01 $ 540.01 APPROVAL Date Reviewed Michael Vieira Building Manager CHECK: $1,802.68 5/17/2004 DIFFERENCE: $0.00 (Should be blank) ' 04-1336 = ' 030-110-083 LAST NAMWFIRST NAME CONTRACTOR • • • CITY/CTY STREET NO • : STREET NAME CITY • ' • USE TYPE !VNEW MH PERM FND B ■ P ■ no MCI 25 char. max VALUATION FLOOD _ PLAN CHECK ACTIVITY Plan Chk-1: Chkd By -1r: _ .Plan Chk-2: -� Chkd By -2: �, Plan Chk-3: Chkd By -3:•_ [255_'char. max, 405853 Return -1: Return -2: Approved: APPLIED 5/11/2004, ISSUED FINALED S M. -- 5/11/04:PDSHERIFF $360; SMIP $7.74; TUA $595; DRAINAGE $510.GLB. REFUND REQUESTED 5-13-04 ITEMS RETURNED TO OWNER SEE FILE. Permit w/Di DEPARTMENT OF DEVELOPMENT SERVICES DEPOSIT SHEET ` BUILDING DIVISION DEPOSIT # 206 BAG # 329 MONEY COLLECTED: I 5113/2004 1 0 Fund Title: BLDG INSP FIRE PRCTN SHER DEV FEE AVA CRT ORD THRM URBN ARA AUD SUSP THRM DRNG Fund: 0010 0100 1800 001,0 1800 1001 1800 Dept: 440001 (SRA), (SHR) 440001 (TUA) (SMTP) (THRM DRNG) Accnt: 4210500 4617240 280 4617252 280. 280 280 Cash: 101001 101001 1011811 101001 1011816 1011430 1011822. 'PERMIT#, RECEIPT#, ., 041331 405846 $ 534.93 041333 405847 $ 549.90, 041333 405848 $ 54.99 $ 305.01 041333 405849 $ 109.98 $ 43.00 041334 405850 $ 1,753.45 023314 405851 $ 54.99 041335 405852 ,. $ 1,042.70 $ 43.00 ,'_. 04;1336 , 405853 .. �_.$;_' 659:88. � �� $_ `'��' 305:;01 $ ; 540.01`.. $ 7.74 $ ',.."510.00 041337 405854 $ 109.98 AVA Court 405855 $ 137.00 405856 $ 54.99 041338 405857 $ 109.98 041339 405857 $ 109.98 032793 405858 $ 109.00 041341 405859 $ 687.38 $ 43.00 041340 405860 $ 714.87 $ 43.00 $ 305.01 $ - 16.73 040497 405864 $ 1,393.10 $ 335.00 041342 405866 $ 467.42 041343 405867 $ 110.00 040035 405868 $ 5.01 041344 405869 $ 54.99 $ 8,687.52 $ 172.00 $ 1,250.03 $ 137.00 $' .540.01 $ 24.47 $ 510.00 GRAND TOTAL TO BE DEPOSITED#$; 1,11,321 03 MONEY COLLECTED: I 5113/2004 1 0 i E BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION APPLICANT NAME OWNER Name VC � Address to LAJg City City D�m- G Le State Zip S Phone` 3 � gK--� Fax E-mail - APPLICANT NAME CONTRACTOR Name Od Address Address City Fax _ City t Phone State Zip J - S Phone Planner Fax E-mail Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City Address Zip City Fax _ State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT NAME Name Address City State Zip Phone Fax _ E-mail APPLICANT SIGNATURE X For office use onI Zoning I Ata I Flood Zone X SRA Yes Occ. Typb Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT 04133(e BP BIN # LOCATTIO^� jN� Ali 4 Property Address l l00 -7 14 Cross Street 0 . WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work - Sq. Footage C1 lell) ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by:^ Amount: � �/• Bldg SRA Receipt M rLD COO - -C'Q Sheriff 4 SMIP 5 iS. � CA GO ra-7 0. Date: at D;Q •(W Total K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 REV 4-30-04 SUBMITTAL REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply fora permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. Residential, New, Remodels, Additions, and Accessory Structures: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPER! ❑ 3. 3 Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. 2 Energy compliance design and supporting documentation: (Note: Not required for additions to with code analysis. ❑ mobile or modular homes.) ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 8. Detached Accessory Building Form, filled out by the property owner .(if required). ❑ 9. Sanitation and site plan approval from the Environmental Health Department. y ❑ 10. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in - Statement of Intent for Non -heated and A/C (if required). ❑ triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer. Mobile, Manufactured, or Modular Homes: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ 4. 2 Floor plans. + ❑ 5. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation and site plan approval from the Environmental Health Department. ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). Commercial, New, Additions and Remodels: ❑ 1. 4 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations, with code analysis. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation (if required). ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Statement of Intent for Non -heated and A/C (if required). ❑ 8. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer. ❑ 9. . Letter of intent. ❑ 10. Hazardous Material Form. ❑ 11. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530) 538-7541. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 4-30-04 NOTES, RESIDENTIAL t i i PERMIT NO, 030-110-083-- -04=1336 — { VANG & YANG, 1687 GRAND AVE, OROVILLE Cont: FLEETWOOD HOMES NEW MH PERM FND THE HCD FORM 433A FOR THIS MH CANNOT BE RECORDED UNTIL ONE OF THE FOLLOWING HAS BEEN TURNED IN TO THE BUILDING DIVISION: (1) LICENSE PLATE(S) OR DECAL (THE INSPECTOR MUST RETREIVE). (2) STATEMENT OF FACTS (ONLY ON NEW MH' S). INSPECTOR TO VERIFY SERIAL & LABEL #'S. SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT. CONDITIONS SUB -STANDARD HOUSING LETTER 0 JOB FINALED (Date) Signature J=OK 0 = Not OK . = NotReadyahle Card B-1 Date Card B-1 MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. 1. Zoning Requirements -Setbacks -Easements Soils; Compaction -Structure Stability 2. Soils; Special MH Support Sketch . 4. 3. Sewer; Location -Test -Fall -C/O -Concrete Elec.; Pool Lighting; 15 Volts-GFI 4. ,Water; Location -Test -Easement Needed (Sketch) Elec.; Enclosures; Conduit Entries -Terminals -Listed 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L -ft. / P Nat. or / /" L "ft./ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector ' 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water; MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports: Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Panel boards- Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK - = Not Applicable . = Not Ready Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel- Bloc kouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/0 -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation RESIDENTIAL (Single & Duplex) Date FRAMING (Continued) Card B-1 Date Card B-1 Date Hangers -Post Caps -Anchors -Connectors Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle Fireplace Ties or Type A Flue -Fireplace Throat Clearance 18. Water Pipe; Test & Anchor -Nail Protection Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 19. D.W.V.; Test Fittings & Anchor -Nail Protection Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 20. Shower Pan; Test, First Floor -Tub Access Garage Fire Protection Framing -RC Channel 21. Test Tub & Shower, Second Floor -Tub Access Property Line Firewall & Openings 22. Gas Pipe; Sixe & Anchors Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 23. Fire Sprinkler; Test Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 59. 24. Fixture & Transformer Clearance -Ins. Protection 60. 25. Elec. Receptacles Spacing -Lights & Switches at Doors 61. 26. Size Boxes & No. of Conductors Stapled 62. 27. Romex Installed Close to Edge of Studs & C.J. 63. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al FINAL (Plans) OK except #'s 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral O Yes O No Ext. Steps -Door & Sidelight Protection -Landings 32. Service -Riser Conductors & Ground Main Disconnect Smoke Detector 33. Equip. Clearances Panels-Motors-Mech. Equip. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 34. Clothes Closet Light -Shower Light -Spa Light Bedroom Exiting 35. Smoke Detector G.F.I. & Bath Fixtures & Tub Access -Spa 69. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 72. 36. A.C. Ducts Insulation & Support 73. 37. Vent Fan, Exhaust above insulation 74. 38. Condensate Drain & Overflow, Size & Grade 75. 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 76. 40. Attic Access & Platform if Furnace in Attic Date Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection Card B-1 Date Card B-1 Date Plb.; Elec. & Mech. Equip. Listed for Location Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) _ 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing 85. A.C. Unit Disconnect, Electrical -Plumbing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door; Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor O Yes _ 83. Following Instld./Drive D Yes D No/Walks O Yes D No/Planters D Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: Y COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION s 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 ` PERMIT APPLICATION DATA SHEET 065 OWNER: I ASSESSOR PARCEL NUMBER a 30 I I o •,d&60� Proposed Building Use: NEW M +••t ►h' e W/ 5 C T1: Counter Technician: Date: Items required in order o apply for a permit. All boxes MUST be checked OR marked NA in or er to apply. it 1. Site plan6, 3 4 sets, signed by the preparer of the plans. Cl 2. Complet�piars, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. Q 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ` 8. Manufactured homes: (p'Data sheets and installation instpMarriage line info, C'Floor Plan,-(,yTie down or fnd plans, all in � duplicate. `-�--�-"'�' ------ ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these -► must be stamped and wet -signed by the engineer. J ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ❑ 14. Hazardous Material Form ❑ 15. Sanitation and site plan approval from the Environmental Health -Department in ❑ Chico ❑ Oroville, as�applicable. ?tom 16. Other Nook- L Ly Le'rrC- n T--rle-,t­�` 7F � Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ ®® 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by . �O 19. Soils Report and/or Engineered Foundation required ........................................... ' �� q c .`'7iD �• n• ❑ 20. Erosion Control Plan Required........................................................................ . -,a �-I 9` 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. a. 14- 0, ¢❑, ;122. City of Chico Plumbing permit........................................................................ t�a 23. California Department of Forestry plan approval ❑ paid. Sent by: ............ 4" 24. Planning approval (A) Use: (B)Parking: (C) Parcel Check: ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... 26. NPDES Form............................................................................................. 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's CQmpensation, Carrier and Policy Number .......................................... Y* 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ 32. Letter of Signature authorization......................................:............................. 6a' 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 34. Manufactured home utility clearance............................................................... ❑ 35. Existing violations and/or expired permits.......................................................... ❑ 36. Deed Restriction........................................................................................ 91' 37.Grant Deed, [�W.H. Title/Statement of Facts, ❑ Leiter-fr raLegal-OwLe[, I heck to H.C.D. $ e 7 may' 38. ther. Pile-eac o r- G+aA j 11-jFF, .E 39. Other: When issued Telephone g -,&q _ 96n- a and hold for pickup. I have been informed of th' alo iie itel� s6anhd rKquirements for obtaining a building permit. Applicant: • -� tip-- ( Date: - //- '9- 0'0y 1. Index permit application for the above items number d: Plan Check Letter 2. Additional items required. ' Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: Date Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541 SCHEDULE OF RECEIPT OF FEES OWNER A.P. # PROPROSED BUILDING USE A/0(0 M# 6 J 60" )�MZ1 DATE RECEIPT # DATE REC. 0 1. BUILDING PERMIT FEES --- Balance Due ..................... $ --- Additional Fees Due........... $ --- Revised Plan Checking Fee.... $ 2. SCHOOL DISTRICT FEES 1t�JJA (paid at School District Office) (form av 'lable aftdr Plip ChS&) 3. SHERIFF FEES (paid at Building t ons) Residential............ X $360.00 =$ 3 0 W Units Commercial (sq. ftg.)..... X $0.03 = $ Sq.Ftg. 4. URBAN AREA FEES (paid at Building Division) Residential (per unit)..... X # Units Amt. Commercial (Sq. Ftg.).... X = $ -�q. rig. Amt. 5. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK FEE $89.00 (paid at Building Division) 8. WATER TENDER FEES BATTALION # $200.00 (paid at Building Division) 9. NORTH CHICO SPECIFIC PLAN (paid at Building Division) Residential Zone X = $ Zone # Units Amt. Commercial (sq. ftg.) ......... X = $ Sq. Ftg. f�j Amt. 10. OTHER 11P ! t time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checking process. APPLICANT , Gke % DATE S\_ J/ Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003) STATE OF CALIFORNIA yfNTat BUSINESS, TRANSPORTATION AND HOUSING AGENCY DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT DIVISION OF CODES AND STANDARDS n REGISTRATION AND TITLING PROGRAM STATEMENT OF FACTS This unit is a: Mobilehome ❑ Commercial Coach ❑ Floating Home ❑ Truck Camper Decal (License) No.(s) Trade Name Serial No.(s) I/We, the undersigned, hereby state: I/We further agree to indemnify and save harmless the Director of Housing and Community Development, State of California, and subsequent purchasers of said unit, for any loss they may suffer resulting from registration of the above-described unit in California, or from issuance of a California certificate of title covering the same. I/We certify under penalty of perjury that the foregoing is true and correct. Executed on 5_11112" (Date) Signature(s) Li— (City) Address 40� Ni/S P,^/ Printed name(s) ,q a'� c C� (State) City !I State c/54IF J- s' 6-f fI MH UT IL. 5168-75E (commercial mobile) PERMIT NO. P I i E M MH UTIL. PERMIT NO. qPERMIT EXPIRES Z a OWNER Edward H. Barron Oroville Pump & Electric, Oroville CONTR. 30-11-62 LOCATION (A.P. ) s/s Grand Ave._approx. 500' W. of 16th St., Oroville y nY Temp. Power Pole Called PG&E ` Tow. Elec. Serv. Called PG&E i' T mp. Gas Serv. Called PG&E JOB f FINALED (Date) Y ) (Sign ure) 7 . I COUNTY OF BUTTE'— DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Sidinq To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. Stemwall Slab Prov. for physically handicapped Heaters Appliances Carport Footings Conformance of ex. structure Gas Piping & Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Reinf. Steel I Final I Fixtures FIRE SPRINKLE Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final '7EC� REMARKS OR CORRECTIONS - 4. odz �W R 0 t 0 J,m, COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS` 7 County Center Drive - Oroville, California 95965 ! Fel ephone: 534-4541 / APPLICATION AND PERMIT Receipt No.4 .;2f6-,ZE 3 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant dhilding permit expires Date ~ 7�' BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address - Telephone No. Fireplace Contractor t�%e-Zi Total Valuation Mailing Address Q �,'7 Permit Fee Plan Checking Fee &/or Penalty adA3Lt"ec Telephone No. is -.740 Permit Fee Building Address PLUMBING Na. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. 8 PI Gas piping system 1 - 5 outlets 1.50 h additional outlet .30 Fqk S i i n Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Oarcel Declaration Parcel Ma p 60' R/W Im rovements p Lawn sprinkler system 2.00 Parcelprovol I Plans prcval Permit Fee $ $ NEW ADDITION ❑ UTILITIES ❑ OTHER [� ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 ,00 - Main service incl. 1 meter �•O�? Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Single Family ❑ Duplex ❑ Mobil Home ❑ Others Rr Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures '2U(d2 - ig Receps., switches & fix outlets CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities ljr� Temp. Power Pole 5.00 License No. �L Y2 g0r0 Classification C -/U Misc. wiring 14— ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ _ $ �- WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. fail I have placed on file with the County of Butte a certificate of -,Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit .is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No.1 @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. XT ai_f;v Date `L,Z �� Signature of Permitee o gent /.s . --. _ TOTAL PERMIT FEE $ / 7Z This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR PUBLIC WORKS By Date Receipt No.4 .;2f6-,ZE 3 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant dhilding permit expires Date ~ 7�' S/0 4 This set of plans and spticif►cc1ti keaf on the l�,y ons MUST` �e at all fir.Ies rnd it is unlawful to Win" . !,N„gPs Or r4nm f ions On some written permission fronj the Deparfine f of ublu Works, Coun y of Buff c 4 NOTE, --All Materials & WoAmarship Shall Be in Accordance vtith Rococsrired G -j-)4 Pr-ctices and of a qur+lity prescr *,bcd for the Spec4*ied use in the Uniform Building, Plumbing & Machanical Codes and the National Electrical Code. �Ilob;le The i. Setback shall be 5 ft, from flip side P`operfy line and 50 ft. from centerline of fhe road '' inum of -a 2 ft. ebve ov perhct,g � t/ e K v Septic system and location a+ ba0d �1 +*-b-e-a- to be ns per Butfe Counfy Health Dept. Ra- quir',ements. 1131 XPD BUM COUNTY BUILDING DEPARTMENT 'APPROVED